Claims Analyst Lumen Solutions Group, Inc.Claims AnalystBaltimore, MDThe ideal candidate will have strong experience in claims research, data validation, data entry, and Excel, with the ability to analyze issues, maintain accurate records, and support day-to-day claims operations. We provide a wide array of experienced business and IT professionals supporting clients from solution design to implementation and support.
NewClaims Analyst III - Nurse Specialist J29, IncClaims Analyst III - Nurse SpecialistMillersville, MDRemoteOverview Performs medical record and claims review for Medicare, Medicaid, and/or other claims data in order to ensure that proper guidelines have been followed and assesses for potential overpayment, fraud, waste, and abuse with regards to Medicare, Medicaid, and/or other claims. Our team brings corporate performance that stretches to various areas where we can provide our clinical, healthcare policy, and compliance expertise through our support to health and human service programs at the State, Federal, and Commercial levels.
Sr. Claims Analyst, Health And Risk Solutions Sun Life FinancialSr. Claims Analyst, Health And Risk SolutionsBaltimore, MD$68,200–$102,300 / yearYou will also play a key role in managing internal and external relationships, supporting new hire training, and coaching and mentoring Health and Risk Solutions Claim Analysts and Overpayment Specialists. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation.
Sr. Claims Analyst, Health and Risk Solutions Sun Life Financial IncSr. Claims Analyst, Health and Risk SolutionsBaltimore, MD$68,200–$102,300 / yearYou will also play a key role in managing internal and external relationships, supporting new hire training, and coaching and mentoring Health and Risk Solutions Claim Analysts and Overpayment Specialists. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation.
Billing and Claims Analyst Porter CaresBilling and Claims AnalystAnnapolis, Maryland$58,000–$75,000 / yearDriven by robust AI analytics, Porter’s Care Guide team helps the member navigate the healthcare delivery system, secures the right support for each member’s specific needs, and directs Porter’s team of expert clinicians to perform comprehensive in-home assessments, complete with lab and diagnostic testing. Our organization operates in a payer-contracted services model — delegated services, in-home assessments, HEDIS gap closure, and risk adjustment visits — billed through Athena in a mix of penny-claim/encounter-reporting and full-cost claim arrangements.
NewSENIOR (MAINFRAME) PROGRAMMER ANALYST - CLAIMS TEAM (IT PROGRAMMER ANALYST, LEAD/ ADVANCED (FULL-TIME CONTRACTUAL)) State of MarylandSENIOR (MAINFRAME) PROGRAMMER ANALYST - CLAIMS TEAM (IT PROGRAMMER ANALYST, LEAD/ ADVANCED (FULL-TIME CONTRACTUAL))Baltimore City, MDExperience: Six years of experience, two years of experience designing, developing, testing, implementing and maintaining applications systems and programs using generally accepted computer programming languages or other developmental tools and an additional four years of experience converting data from project specifications by writing program code using generally accepted computer programming languages or other developmental tools. Candidates may substitute the possession of a Bachelor''s degree from an accredited college or university in Information Technology, Computer Science, Management Information Systems, or other information technology related field and two years of experience designing, developing, testing, implementing and maintaining applications systems and programs using generally accepted computer programming languages or other developmental tools for the required experience.
EPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full Time SolutionHealthEPIC Applications Analyst (1-4): Hospital Billing Admin and Hospital Billing Claims - IT Services - Full TimeMDEpic Application Analysts 2-4 require current Epic training status (certification, accreditation, and/or proficiency) in primary application required, with a combination of current Epic training statuses in additional area(s) in application maintenance and development required in upper levels. Ideal candidates will possess strong experience as analyst with expert knowledge and experience in leading system analysis with special emphasis on system methodologies, projects management and business process reengineering related to information systems required.
Healthcare Claims Functional Analyst Glint Tech Solutions LLCHealthcare Claims Functional AnalystBaltimore, MDThe role also involves providing operational support, root cause analysis, testing, and documentation to ensure efficient claims processing operations. Research and resolve operational and systems issues by gathering facts, identifying root causes, and facilitating practical solutions.
Healthcare Claims Functional Analyst Glint Tech SolutionsHealthcare Claims Functional AnalystBaltimore, MarylandThe role also involves providing operational support, root cause analysis, testing, and documentation to ensure efficient claims processing operations. Research and resolve operational and systems issues by gathering facts, identifying root causes, and facilitating practical solutions.
NewCommercial Claims Insurance Analyst - Remote CSAA Insurance GroupCommercial Claims Insurance Analyst - RemoteMDRemote$99,855–$110,950 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arizona - Home Teleworkers, Arkansas - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers {+ 15 more}. Your Work: Performs complex data analysis for assigned client groups, evaluating findings in relation to broader business objectives Collaborates with cross-functional partners outside of IPM/IPO to gather insights, validate findings, and gain alignment on recommended actions.
Stop Loss Claims Resolution Consultant Sun Life Financial IncStop Loss Claims Resolution ConsultantBaltimore, MD$54,100–$81,200 / yearThis role combines deep technical expertise as a Stop Loss Health Claims Analyst with responsibility for managing end-to-end inquiry resolution, including research, claim determination support, documentation review, and clear customer communication. Through employers, industry partners and government programs, Sun Life U.S. offers a portfolio of benefits and services, including dental, vision, disability, absence management, life, supplemental health, medical stop-loss insurance, and healthcare navigation.
🟢 Green — Claims Compliance & Reporting Analyst Funtonetwork🟢 Green — Claims Compliance & Reporting AnalystCalifornia, CaliforniaIf you applied for Green — Claims Compliance & Reporting Analyst - Buyer Agency - MB-10395 , you may request an optional paid FuntoNetwork self-interview instead of waiting for a procurement award or client interview timeline to become available. At FuntoNetwork, we connect experienced consultants with Upcoming project opportunities through a mobile-first platform built for discovery, review, application submission, payment tracking, and consultant support.
Claims Coordinator Perdue Farms IncClaims CoordinatorSalisbury, MDHighlight issues and trends to the Claims Supervisor and Claims Analyst.\n Recommend solutions to reduce the occurrence of errors that lead to customer claims.\n \nMinimum Education and Experience\n\n High School Diploma or equivalent.\n 1 - 2 years of related work experience.\n Demonstrate strong customer service skills.\n Effectively communicate with customers, brokers, and sales representatives to obtain required documentation.\n This opportunity is ideal for a detail-oriented professional who enjoys problem solving, collaborating across teams, and identifying process improvements that help reduce claim-related issues and drive operational excellence.\n \nThis position has a target wage of $20.00 - $30.00 per hour, based on shift, experience and qualifications with annual bonus available (variable depending on performance).
NewStop Loss Aggregate Analyst CVS Health CorpStop Loss Aggregate AnalystMD$18.50–$35.29 / hourThis role involves preparing, tracking, reconciling, and helping generate and marshal stop loss filings to completion while serving as a key liaison across internal business partners, external stakeholders, and stop loss carriers. The position offers exposure to many areas of healthcare claims administration, including stop loss and reinsurance policy, data analytics, underwriting, eligibility, finance, client management, and provider and broker relations.
Portfolio Operations Analyst ProSharesPortfolio Operations AnalystBethesda, MDComplete the processing, research and collection of all corporate action related activity including, but not limited to: Cash Dividends, Stock Dividends, Stock Splits, Spin Offs, Cash & Stock Mergers, Tender Offers, Rights Subscriptions, Full & Partial Calls, and Maturities. Rare opportunity to develop expertise across virtually every major asset class—including ETFs, mutual funds, swaps, futures, options, fixed income, equities, repo, and global markets—rather than specializing in a single product area.
Junior Health Data Analyst - Hybrid/On Site Greater Baltimore Medical CenterJunior Health Data Analyst - Hybrid/On SiteTowson, MD$58,488.99–$93,582.39 / yearUnder general supervision, works collaboratively across teams within GBMC to develop and maintain data collection, measurement tools, and databases to support data analysis in support of health improvement initiatives, value-based care programs, and other health outcome data monitoring requirements. Works with the clinical and financial teams to identify trends and patterns in these complex data sets, draws conclusions, develops graphical and narrative summaries utilizing charts, graphs and images to appropriately display the information for presentation to stakeholders.
Leave of Absence Analyst - Baltimore SyscoLeave of Absence Analyst - BaltimoreJessup, MDReturn to Work: Review and audit Return to Work process for claims, including Return to Work transitional program, process with external vendor and internal business units to ensure compliance including Return to Work transitional program. The Leave of Absence Analyst is responsible for managing employee leave and return to work processes, ensuring a smooth process for colleagues while adhering to legal requirements and company policies.
NewSenior Plan Analyst (Administrative Officer III) State of MarylandSenior Plan Analyst (Administrative Officer III)Baltimore City, MDAs the Insurance Plan Compliance (IPC) Team, we work collaboratively with other teams within the FAMLI Division, including Digital Services, Public Engagement, Employer Services, and Claims and Benefits to serve the Insurance Plan participants in the most effective and efficient manner.Ă‚. Reports issues of noncompliance involving Employers and/or Insurers to Plan Analysis Assistant Manager.Ă‚ Provides applicable documentation regarding issues of noncompliance to the Plan Analysis Assistant Manager.Ă‚.
Portfolio Operations Analyst ProShares Trust IIPortfolio Operations AnalystBethesda, MDComplete the processing, research and collection of all corporate action related activity including, but not limited to: Cash Dividends, Stock Dividends, Stock Splits, Spin Offs, Cash & Stock Mergers, Tender Offers, Rights Subscriptions, Full & Partial Calls, and Maturities. What Sets This Role Apart: Rare opportunity to develop expertise across virtually every major asset class-including ETFs, mutual funds, swaps, futures, options, fixed income, equities, repo, and global markets-rather than specializing in a single product area.
Commercial Insurance Analyst - Remote CSAA Insurance GroupCommercial Insurance Analyst - RemoteMDRemote$122,850–$136,500 / yearAlabama - Home Teleworkers, Alabama - Home Teleworkers, Arkansas - Home Teleworkers, Colorado - Home Teleworkers, Connecticut - Home Teleworkers, Delaware - Home Teleworker, District of Columbia - Home Teleworkers, Florida - Home Teleworkers, Georgia - Home Teleworkers, Idaho - Home Teleworkers, Illinois - Home Teleworkers, Indiana - Home Teleworkers, Iowa - Home Teleworkers, Kansas - Home Teleworker, Kentucky - Home Teleworkers, Louisiana - Home Teleworkers, Maine Home Teleworkers, Maryland - Home Teleworkers, Massachusetts - Home Teleworkers, Michigan - Home Teleworkers, Minnesota - Home Teleworkers, Mississippi - Home Teleworker, Missouri - Home Teleworker, Montana - Home Teleworkers, Nebraska - Home Teleworkers {+ 20 more}. Pursuit or completion of industry-relevant continuing education, including graduate degrees, MBS, risk and insurance designations from The Institutes (AINS, AIC, ARM, CPCU, etc.), or actuarial exams and designations (ACAS, FCAS, CERA).